This invention concerns systems for deploying, supporting and organizing medical equipment and essential medical utilities at a patient's bedside
Medical treatment facilities deploy numerous and diverse bedside medical devices in support of seriously ill or injured patients. Many of these devices are connected to hospital utilities through wall outlets that deliver, for example oxygen, suction, compressed air, electric power, including standard and emergency power, low voltage electricity, nurse call lines, computer network connections, communications wiring, lighting, and similar utilities used in administering medical services at high levels of care.
Typical devices deployed bedside support therapies, diagnostics, monitoring, emergency intervention and communications. These include infusion pumps, blood warmers, oxygen catheters, suctioning devices, air/oxygen blenders, gas flow meters, sphygmomanometers, monitors for ECG, heart rate and blood pressure, emergency call buttons, nurse intercoms, telephones, computer terminals, and other devices. In addition, there is a corollary need for specialized storage, such as sharps containers, surgical gloves, catheters, and other items used in intensive patient care.
The devices and storage items used in intensive care are typically gathered into systems for their deployment, support and organization. Traditionally, such systems include headwall systems in both vertical and horizontal designs installed behind the patient bed to deliver hospital utilities such as gases, power, and communications through outlets located behind the head of the patient bed and flat against the wall. Headwall systems are expedient for routing utilities through walls, but they impede free access by care givers to both the patient's head and to the support equipment and utility outlets. Headwall systems are depicted in U.S. Pat. Nos. 5,553,982 and 5,756,933.
More recently, medical support equipment has been moved from the wall behind a patient's head and consolidated in cabinet-like structures placed next to the bed near a patient's head to conserve useable floor space, improve circulation in the room and provide access to the patient's head. These support systems include free standing systems with generally rectangular footprints, systems entirely suspended from articulated ceiling arms, and systems that are supported both from floor and ceiling, such as those depicted in U.S. Pat. Nos. 5,107,636 and 5,618,690. Utility outlets in such systems generally are presented to care givers in horizontal strips, with the devices or equipment attached externally to the system.
Treatment facilities for the intensive care of critically ill patients, such as medical, cardiac or neonatal intensive care units, are extremely stressful environments for care givers and patients. Increasing emphasis is being given to humanizing this environment by toning down the sight and sounds of complex equipment and, when possible, incorporating the attendance and psychological support of members of patients' families in the healing process of the critically ill. Not surprisingly, the presence of family members is placing new emphasis on reducing visual clutter and noise levels in the layout and design of equipment at the patient's bedside. Existing support equipment is too overbearing, and the environment is too impersonal, noisy and frightening to make patients and family members feel at ease. Furthermore, the presence of family members makes circulation around beds, equipment and people much more difficult for the care giving staff. Presently available headwall system and free-standing or ceiling supported systems are inadequate for these new requirements. Specifically, present systems exemplified by U.S. Pat. No. 5,107,636, are large, bulky, angular and not user friendly because they expose the equipment they organize to the environment on all sides. Equipment generally is attached in such systems by means of straight, horizontal equipment rails positioned near the periphery of the main enclosure so the equipment projects beyond the systems' perimeter, significantly increasing the operational footprint of the system. Additionally, equipment attached externally to these systems in this manner is even more visually overwhelming and a hazard to the circulating staff.
Interpersonal communications among staff require visual and auditory contact across the room. Existing systems, exemplified by U.S. Pat. Nos. 5,107,636 and 5,618,690, provide open viewing passages through their interior space. These open areas, however, usually are traversed by many permanent structural elements and supports for equipment and outlets that effectively reduce this openness. Because of the permanent nature of such traversing structures and elements, the care giving staff has limited freedom in arranging these systems and can not always place equipment to achieve best productivity. If equipment is attached to such systems' equipment rails so it projects inward rather than out, the controls of these devices face inward away from the user, and access to them is further obstructed by the rail and mounting clamps.
It is crucial to reduce opportunities for error on the part of care givers, particularly under the stress of intensive patient care. In known systems, equipment is arranged based on a horizontal organizing principle, which may make it difficult to clearly distinguish equipment belonging to particular groupings such as a patient on the left or right side, or to a particular therapeutic procedure. This may increase the risk of error.
Furthermore, when outlets are contained in known horizontal raceways and strips, such as shown in U.S. Pat. Nos. 5,107,636 and 5,618,690, outward-facing electrical plugs, hanging cables and hanging hoses create a curtain that obstructs and obscures user access to the open area on the systems' interior. Typically, certain devices including flow meters and blenders are plugged directly into the gas outlets positioned in the outlet strips. When these devices project outward beyond the systems' footprint, they are exposed and vulnerable.
Infection control is another important issue in intensive patient care facilities. Present systems impede cleaning and the control of dust because they incorporate many permanent, horizontal frames, bars, channels, and structures where horizontal and cross members meet. Crevices at these joints can accumulate dust and are difficult to clean. Also, casters and wheels impede efficient floor cleaning, and top surfaces above eye level are typically not slanted for easy wiping access.
Cost is an essential issue in health care. Capital outlays for known systems are significant because these systems are large, heavy, complex, and do not offer the flexibility to be configured and reconfigured to support different levels of care and other applications. Installing known systems is costly when they require expensive articulated structures to connect them to the ceiling, or when they do not have a detachable floor mounting base or wall mounting bracket that enable rough-in installation without the entire, fully-assembled system being installed. Maintaining known systems can be costly because it is not easy to gain open access to the service side of all outlets and cable ways for replacement of outlets or to add a new circuit.
Moreover, productivity and work flow inefficiencies present other additional costs when known systems do not allow a facility or an individual care giver the freedom to arrange a work space as desired. Known systems do not allow easy upgrading, additions, modifications or re-deployment when other, greater or lesser levels of care are required.
Adjustability of systems is desirable to allow staff to position equipment where needed. Many known systems cannot be adjusted, provide no toe space for the user, and require an unsightly, laterally attached wiring chase extending to the ceiling. Other known systems are moveable, but require an elaborate, costly and visually imposing articulated structure to conduct utility lines from the ceiling, and a wheeled base that creates cleaning problems.
For the foregoing reasons, there is a need for a low cost, modular and versatile medical equipment and utilities system that contains support equipment and storage items associated with patient care within its perimeter, permits care givers to arrange equipment easily and quickly to support individual working styles, and allows equipment to be easily and meaningfully grouped and regrouped. There is a need for a system that conceals all utility cables and hoses, presents utility outlets at a user-friendly angle, and provides a means for attaching accessories that enable patient's families to personalize the bedside, permits easy access for on-site service, repair and expansion, and can be rapidly installed with minimum disruption of an existing facility.